CC BY 4.0 · Surg J (N Y) 2020; 06(01): e47-e48
DOI: 10.1055/s-0040-1701695
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Middle Hepatic Vein Injury during Laparoscopic Cholecystectomy: A Case Report

1  Department of General Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
2  Department of General Surgery, Universidad El Rosario, Bogotá, Colombia
,
1  Department of General Surgery, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
,
3  Department of Metabolic Support and Surgery for Intestinal Failure, Hospital Universitario Fundación Santa Fé de Bogotá, Bogotá, Colombia
,
3  Department of Metabolic Support and Surgery for Intestinal Failure, Hospital Universitario Fundación Santa Fé de Bogotá, Bogotá, Colombia
› Author Affiliations
Further Information

Publication History

23 November 2018

22 March 2019

Publication Date:
09 March 2020 (online)

  

Abstract

Background Cholecystectomy continues to be the first choice for the treatment of symptomatic cholelithiasis. Especially in patients with acute cholecystitis, a laparoscopic approach has become the standard treatment option. Intraoperative complications of laparoscopic cholecystectomy include: bile duct injury, organ damage, and bleeding due to vascular injury. Difficult hemorrhage during laparoscopic cholecystectomy occurs in 0.1 to 1.9% of all cases. Besides major vessel injuries, gallbladder bed vasculature is reported as a common injury site, mostly secondary to middle hepatic vein lesions.

Case Presentation We present a case report of a patient taken for a laparoscopic cholecystectomy. During the procedure, inadvertent middle hepatic vein injury occurs. Here we describe the management approach selected for this type of injury.

Discussion We recommend careful dissection during the final steps of a laparoscopic cholecystectomy. Following cystic duct and cystic artery ligation, surgeons often inappropriately relax through the last part of the dissection. During this final dissection, if care is not taken, small vascular structures can be missed and injured.